At present, there is little to no special notification within VistA/CPRS of normal, abnormal or incomplete test results, such as those indicative of a cancer. Critical alerts occur in the system, but very little tracking, follow-up information, special notification or decision support occurs, other than what is present in VA’s base system. The Alert Watch and Response Engine (AWARE) is an automated tool that enables clinicians, supervisors and administrators to monitor and track responses to CPRS critical alerts, with an initial emphasis on cancer-related alerts. It consists of three basic functions: (1) an alert monitor (2) an alert tracker for follow-up actions and (3) a viewing/reporting engine.
• Tracks critical alerts and monitor follow-up action.
• Identifies critical lab and imaging test result alerts that lack timely follow-up.
• Provides an prompt to notify the user that an unacknowledged, abnormal result alert type exists for a patient that has not had follow-up.
• Allows for a decision-support workflow that guides the user towards appropriate follow-up actions desired for that alert through the use of regular Reminder dialogs.
AWARE identifies a list of certain critical lab and imaging test result alerts that lack timely follow-up in a web-based Alert Viewer, which is accessible as a standalone application or via a call-up though the Tools menu in CPRS. AWARE also consists of a web-based Knowledge Base editor to define critical alert types and categories and a web-based Quality Indicating reporting tool.
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